METHODOLOGY: Data were extracted from databases, such as PubMed, Springer Link, Science Direct, Google Scholar and general search engines, by using pre-determined keywords (e.g. clinico-pathological data, age, sex, tumour stage, nasopharyngeal cancer, nasopharyngeal carcinoma, naso-pharynx and cancer in Asia).
RESULTS AND CONCLUSION: Findings from our systematic review shows that from 2010 to 2021, males in age range below 50 years old are at a higher risk of developing NPC in Asia. NPC is mostly diagnosed at advanced stage in Asia, which is likely due to the deep-seated location of the cancer. Type III NPC and EBV proteins (EBNA1 and LMP2A) are frequently associated with reported EBV-positive NPC cases in Asian countries. Meanwhile, NPC type I, II, and III are associated with EBV-negative NPC cases in Asia. Human leucocyte antigen (HLA) alleles (A2, B27, and B46) are frequently present in reported EBV-negative NPC cases in Asia. In Asia, males below 50 years old are more prone to NPC and often diagnosed at late stage. EBV-positive and EBV-negative NPC in Asia have unique histological profiles. Systemic approach of this study may help to provide better knowledge on reported NPC cases especially on the risk factors and clinical presentation focusing in Asian countries.
METHODS: Search for related literature on salted fish,
smoking and alcohol consumption were performed via Science Direct, PubMed databases and Google Scholar. Articles
included in this study were from 2009 to 2017, with specific focus on salted fish, smoking and alcohol consumption
as risk factors of NPC. This study excluded all articles published prior to 2009 and articles involving other cancers.
Data were extracted independently by two different researchers and harmonized. Meta-analysis was conducted on the
obtained data, by using R package Meta to create funnel and forest plots.
RESULTS: The meta-analysis revealed that
salted fish, smoking and alcohol consumption were significantly associated to NPC risk with random effect model score
showing OR of 1.41 at 95% confidence interval (CI) of 1.13-1.75 (P<0.01), OR of 1.89 at 95 % CI of 1.49 - 2.38, and
OR: 1.42 at 95 % CI of 1.23 - 1.65 respectively. Our results also revealed significant association of salted meat, salted
vegetables, house type, wood dust exposure associated with NPC risk with p values less than 0.05.
CONCLUSION: This
study proposes that salted fish intake, smoking and alcohol consumption might be linked to NPC risk in Asians. Further
studies are necessary to ascertain the molecular mechanisms and clarify if the associated path that could function as
therapeutic target.